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Childhood Asthma

Childhood asthma has become more widespread in recent decades. As the most common chronic illness in children, childhood asthma causes more missed school and places more limits on activity than does any other disease.

What is it?

Childhood asthma has become more widespread in recent decades. As the most common chronic illness in children, childhood asthma causes more missed school and places more limits on activity than does any other disease. Childhood asthma and adult asthma have the same underlying cause — inflammation of the airways. This inflammation makes the airways overly sensitive, leading to signs and symptoms that range from minor coughing or wheezing to serious flare-ups that interfere with breathing.

Fortunately, childhood asthma is treatable. Although childhood asthma can't be cured, you and your child can keep symptoms under control with a written plan, monitoring, regular doctor visits and making treatment changes as needed.

Symptoms

Childhood asthma can be very disruptive, causing bothersome daily symptoms that interfere with play, sports, school and sleep.

In some children, unmanaged asthma can cause serious or even life-threatening asthma attacks.

Common childhood asthma symptoms include:

Coughing

A whistling or wheezing sound when exhaling

Shortness of breath

Chest congestion or tightness

Other signs and symptoms of asthma in children include:

Trouble sleeping caused by shortness of breath, coughing or wheezing

Bouts of coughing or wheezing that get worse with a respiratory infection such as a cold or the flu

Delayed recovery or bronchitis after a respiratory infection

Fatigue or trouble breathing during active play or exercise — signs of exercise-induced asthma

Asthma signs and symptoms vary from child to child, and may get worse or better over time. While wheezing is most commonly associated with asthma, not all children with asthma wheeze. Your child may have only one sign or symptom, such as a lingering cough or chest congestion.

Sometimes it's difficult to tell whether your child's symptoms are caused by asthma. Wheezing episodes and other asthma-like symptoms may be caused by infectious bronchitis or other respiratory problem.

Causes

In children with asthma, an overly sensitive immune system makes airways become inflamed and swollen when exposed to triggers such as smoke or allergens. Sometimes, asthma symptoms occur with no apparent triggers. When asthma flares up, airway muscles constrict, the lining of the airways swell, and thick mucus fills the bronchial tubes, leading to asthma symptoms.

Asthma triggers differ from child to child and include:

Viral infections such as the common cold

Allergens such as dust mites, pet dander, pollen or mold

Tobacco smoke or other environmental pollutants

Exercise

Weather changes or cold airConditions linked to asthma include:

A chronic runny or stuffy nose (rhinitis)

Inflamed sinuses (sinusitis)

Heartburn (gastroesophageal reflux disease)

Risk factors

It isn't clear why some children get asthma and others don't, but it's probably due to a combination of genetic (inherited) and environmental factors. Children with a family history of asthma are at greater risk of developing the disease. Other environmental factors that may increase your child's chances of developing asthma include:

Complications

Side effects from long-term use of some medications used to stabilize severe asthma (oral corticosteroids)

Slightly slowed growth in children caused by long-term use of inhaled corticosteroids

Diagnosis

Asthma is a very individual condition. Your child's doctor will consider the nature and frequency of symptoms along with results from tests to rule out other diseases before diagnosing asthma.

First, the doctor will ask for a detailed description of your child's symptoms and ask about your family history of asthma or allergic diseases such as eczema, hives or allergic rhinitis (hay fever).

In children 6 years of age and older, doctors diagnose asthma with the same tests used to identify the disease in adults. Lung function tests (spirometry) measure how quickly and how much air your child can exhale. Your child may have pulmonary function tests at rest, after exercising and after taking asthma medication. Allergy tests also may be part of the evaluation.

In younger children, diagnosis can be difficult because lung function tests aren't accurate before 6 years of age. Some children also simply outgrow asthma-like symptoms over time. Your doctor will rely on detailed information about symptom type and frequency when considering an asthma diagnosis in a young child. Sometimes a diagnosis is not made until later, after months or years of observing symptoms.

If you suspect your child has asthma, it's important to start the testing process early. Early diagnosis and proper treatment can prevent disruptions from daily activities such as sleep, play, sports and school. It may also prevent dangerous or even life-threatening asthma attacks.

For children younger than age 3 who have symptoms of asthma, many times doctors will use a "wait-and-see" approach. This is because the long-term effects of asthma medication on infants and young children aren't clear. If an infant or toddler has frequent or severe wheezing episodes, a course of medication may be prescribed to see if the wheezing improves symptoms.